Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.05 / $155.31 / $173.76	Facility		$150.05	$155.31	$173.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $92.56 / $187.61	Professional		$45.68	$92.56	$187.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.69 / $636.79 / $835.09	Facility		$52.69	$636.79	$835.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.07 / $147.16 / $209.68	Professional		$94.07	$147.16	$209.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $137.13 / $162.77 / $188.23	Professional		$137.13	$162.77	$188.23
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $60.58 / $127.10 / $216.01	Facility		$60.58	$127.10	$216.01
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $129.60 / $220.68	Professional		$111.50	$129.60	$220.68
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $106.11 / $137.13 / $164.16	Facility		$106.11	$137.13	$164.16
Providence Facility/Professional Facility Modifier Low / Median / High Price $72.50 / $168.06 / $217.35	Facility		$72.50	$168.06	$217.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $120.69 / $159.90 / $201.76	Professional		$120.69	$159.90	$201.76
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $656.85 / $782.93 / $962.78	Facility		$656.85	$782.93	$962.78
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $123.89 / $153.72 / $196.13	Professional		$123.89	$153.72	$196.13
United Facility/Professional Professional Modifier Low / Median / High Price $82.18 / $100.84 / $213.97	Professional		$82.18	$100.84	$213.97